Retrospective analysis of guided access technique in calcified canals using cone beam tomography and digital scanning.

Abstract

<h4>Introduction</h4>The endodontic treatment of teeth presenting with calcified pulp is associated with significant technical difficulties.<h4>Aim</h4>To evaluate the success rate of the guided access technique for root canals using cone beam computed tomography (CBCT) between 2019 and 2021.<h4>Material and method</h4>The study selected cases of anterior and posterior teeth with severe pulp calcification, totaling 100 teeth including 59 incisors, 2 canines, 8 premolars, and 31 molars. CBCT scans were performed for all patients, and a virtual burr path was planned on a computer screen to guide the drill to the beginning of the root canal. The virtual drill path was delineated based on axial and cross-sectional tomographic data, and a template was fabricated using Computer Numerical Control (CNC) technology. Success was determined by reaching the canal lumen without deviation from the original path.<h4>Results</h4>The success rate of the guided access technique was 99.1%, with calcification diagnosed in 48.7% of cases. Clinical history revealed deep restoration and necrosis in 34.8% of cases, and trauma in 34.8%. In 65.2% of cases, an attempt was made before referral for guided access.<h4>Conclusion</h4>The guided access technique demonstrated high success rates, particularly when appropriately indicated. Clinical relevance: Guided access technique provides a reliable option for managing calcified root canals, thereby improving treatment outcomes.